tbuckley/cabot-search huggingface dataset:
Impact of appropriateness in clinical practice: data from a single-centre nuclear cardiology laboratory
Authors: Riccardo Liga, Dario Grassini, Assuero Giorgetti, Enrico Grasso, Stefano Dalmiani, Alessia Gimelli
Journal:  (2023)

Abstract Aims To verify the level of appropriateness of referral to our nuclear cardiology laboratory for stress myocardial perfusion imaging (MPI) and explore the correlation between test appropriateness patterns and ischaemia. Methods and results In 1870 consecutive patients (mean age 73 ± 12 years; 33% female) undergoing MPI, the level of imaging test appropriateness was evaluated according to the 2023 Appropriate Use Criteria (AUC) and the current European Society of Cardiology (ESC) guidelines for the management of chronic coronary syndromes. The evidence of moderate-to-severe ischaemia (i.e. summed difference score &amp;gt;7) was recorded. According to the AUC criteria, the MPI of 1638 (88%), 130 (7%), and 102 (5%) patients could be classified as ‘appropriate’, ‘inappropriate’, and ‘uncertain’, respectively. Similarly, in 1685 (90%) patients, the referral to MPI was adherent to ESC guidelines, while in 185 (10%), it was not. The majority of appropriate MPI tests showed the presence of moderate-to-severe ischaemia (55%), while only a limited number (10%; P &amp;lt; 0.05) of MPI tests with uncertain clinical appropriateness or clearly inappropriate indications did not. In patients managed adherently to ESC guidelines, invasive coronary angiography more frequently showed obstructive coronary artery disease (CAD) (93 vs. 47%, P &amp;lt; 0.001) and led to coronary revascularization (65 vs. 23%, P &amp;lt; 0.001) compared with patients managed non-adherently. Conclusion In a single-centre, single-national, single-modality population, the current rate of appropriate MPI tests is high. Appropriate referrals are associated with a higher probability of moderate-to-severe ischaemia and better downstream resource utilization than inappropriate ones.
Improving autism identification and support for individuals assigned female at birth: clinical suggestions and research priorities
Authors: Meng-Chuan Lai, Anouck Amestoy, Somer Bishop, Heather M Brown, Morénike Giwa Onaiwu, Alycia Halladay, Clare Harrop, Emily Hotez, Marisela Huerta, Amy Kelly, Dylan Miller, Christine Wu Nordahl, Allison B Ratto, Celine Saulnier, Paige M Siper, Kristin Sohl, Lonnie Zwaigenbaum, Sylvie Goldman
Journal: The Lancet Child & Adolescent Health (2023)
Prospective associations between ADHD symptoms and physical conditions from early childhood to adolescence: a population-based longitudinal study
Authors: Cédric Galera, Ophélie Collet, Massimiliano Orri, Marie Navarro, Laura Castel, Charline Galesne, Claire Reed, Valerie Brandt, Henrik Larsson, Michel Boivin, Richard Tremblay, Sylvana Côté, Samuele Cortese
Journal: The Lancet Child & Adolescent Health (2023)
Association between air raids and reported incidence of cholera in Yemen, 2016–19: an ecological modelling study
Authors: Maia C Tarnas, Najwa Al-Dheeb, Muhammad H Zaman, Daniel M Parker
Journal: The Lancet Global Health (2023)

Yemen continues to endure cholera outbreaks during ongoing conflict and destructive environmental events. Air raids have been used throughout the conflict to target military and civilian infrastructure. We aimed to assess the association between air raids and cholera incidence while taking into account geographical, environmental, economic, and demographic factors that drive outbreaks.In this ecological modelling study, we used data from Sept 12, 2016, to Dec 29, 2019, for the number of air raids, vegetation coverage, surface water, precipitation, temperature, economic variables, and cholera case and population data to model the association between conflict and the weekly incidence of cholera (per 100 000 people) in Yemen. Data were transformed into weekly intervals and governorates were categorised according to air raid severity (the number of raids in the previous 3 months). We used a negative binomial generalised additive model that accounted for geographical location and environmental, temporal, economic, and demographic variables to estimate incidence rate ratios for the association between air raid severity and cases of cholera.During the study period, 2 107 912 cases of cholera were reported in Yemen, and a minimum of 11 366 air raids were recorded. After controlling for relevant factors, compared with no air raids, all other levels of air raid severity were significantly associated with cholera incidence. The largest effect was noted in governorates with severe air raid levels (ie, ≥76 during the previous 3 months), which had an incidence rate ratio of 2·06 (95% CI 1·59-2·69; p<0·0001) for cholera compared with governorates with no air raids in the previous 3 months. Economic factors were also significantly associated with increased cholera incidence.Air raids were significantly associated with the burden of cholera in Yemen, even after controlling for other relevant factors. Quantification of this relationship further shows that the cholera outbreak is largely a result of human action rather than a natural occurrence, and demonstrates the conflict's devastating effects on health. Our findings highlight the need for ceasefire and peacebuilding efforts, as well as infrastructure and economic restoration, to reduce Yemen's cholera burden.None.For the Arabic translation of the abstract see Supplementary Materials section.
Is intimate partner violence declining in low-income and middle-income countries?
Authors: Anita Raj
Journal: The Lancet Global Health (2023)

Global estimates of intimate partner violence suggest that 27% of ever-partnered women aged 15–49 years have experienced physical or sexual intimate partner violence in their lifetime, and 13% report intimate partner violence over the past year.1 These experiences disproportionately affect women in low-income and middle-income countries compared with high-income countries, with past-year intimate partner violence prevalence at 32% in central Africa and 24% in eastern sub-Saharan Africa, at 19% in South Asia, and at 4–6% in Europe and North America.
The imperative of good governance and enhanced learning systems for resilient health financing
Authors: Leila Doshmangir, Reza Majdzadeh
Journal: The Lancet Global Health (2023)

After the COVID-19 pandemic, health systems prioritised the mitigation of human casualties caused by SARS-CoV-2, addressing the post-COVID-19 condition (also known as long COVID), and grappling with other ramifications of the pandemic, including the disruption and postponement of essential health services, an increased burden of mental health disorders, and shortages of essential medical supplies. The pandemic highlighted the fragility of health financing policies, particularly in countries with vulnerable economic situations.
Reimagining family planning: beyond opinion leaders and service uptake indicators
Authors: Mallah Tabot, Beth Schlachter
Journal: The Lancet Global Health (2023)

In The Lancet Global Health, Agrey H Mwakisole and colleagues1 explore the role of Christian religious leaders in promoting family planning in rural Tanzania. Given the roles that religious leaders can hold as trusted community messengers, the Article provides strong recommendations for including them in family planning initiatives, suggesting that, as an innovative and adaptable strategy, it could contribute positively to global initiatives towards universal access to modern contraception, if implemented broadly.
Genomic and transcriptomic advances in amyotrophic lateral sclerosis
Authors: Mafalda Rizzuti, Luca Sali, Valentina Melzi, Simone Scarcella, Gianluca Costamagna, Linda Ottoboni, Lorenzo Quetti, Lorenzo Brambilla, Dimitra Papadimitriou, Federico Verde, Antonia Ratti, Nicola Ticozzi, Giacomo Pietro Comi, Stefania Corti, Delia Gagliardi
Journal: Ageing Research Reviews (2023)

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder and the most common motor neuron disease. ALS shows substantial clinical and molecular heterogeneity. In vitro and in vivo models coupled with multiomic techniques have provided important contributions to unraveling the pathomechanisms underlying ALS. To date, despite promising results and accumulating knowledge, an effective treatment is still lacking. Here, we provide an overview of the literature on the use of genomics, epigenomics, transcriptomics and microRNAs to deeply investigate the molecular mechanisms developing and sustaining ALS. We report the most relevant genes implicated in ALS pathogenesis, discussing the use of different high-throughput sequencing techniques and the role of epigenomic modifications. Furthermore, we present transcriptomic studies discussing the most recent advances, from microarrays to bulk and single-cell RNA sequencing. Finally, we discuss the use of microRNAs as potential biomarkers and promising tools for molecular intervention. The integration of data from multiple omic approaches may provide new insights into pathogenic pathways in ALS by shedding light on diagnostic and prognostic biomarkers, helping to stratify patients into clinically relevant subgroups, revealing novel therapeutic targets and supporting the development of new effective therapies.
Improvement of adenoma detection rate by two computer-aided colonic polyp detection systems in high adenoma detectors: a randomized multicenter trial
Authors: Kasenee Tiankanon, Satimai Aniwan, Stephen J Kerr, Krittaya Mekritthikrai, Natanong Kongtab, Naruemon Wisedopas, Panida Piyachaturawat, Santi Kulpatcharapong, Sittikorn Linlawan, Poonrada Phromnil, Puth Muangpaisarn, Theerapat Orprayoon, Jaruwan Chanyaswad, Panukorn Sunthornwechapong, Peerapon Vateekul, Pinit Kullavanijaya, Rungsun Rerknimitr
Journal: Endoscopy (2023)

Abstract Background This study aimed to evaluate the benefits of a self-developed computer-aided polyp detection system (SD-CADe) and a commercial system (CM-CADe) for high adenoma detectors compared with white-light endoscopy (WLE) as a control. Methods Average-risk 50–75-year-old individuals who underwent screening colonoscopy at five referral centers were randomized to SD-CADe, CM-CADe, or WLE groups (1:1:1 ratio). Trainees and staff with an adenoma detection rate (ADR) of ≥35% were recruited. The primary outcome was ADR. Secondary outcomes were the proximal adenoma detection rate (pADR), advanced adenoma detection rate (AADR), and the number of adenomas, proximal adenomas, and advanced adenomas per colonoscopy (APC, pAPC, and AAPC, respectively). Results The study enrolled 1200 participants. The ADR in the control, CM-CADe, and SD-CADe groups was 38.3%, 50.0%, and 54.8%, respectively. The pADR was 23.0%, 32.3%, and 38.8%, respectively. AADR was 6.0%, 10.3%, and 9.5%, respectively. After adjustment, the ADR and pADR in both intervention groups were significantly higher than in controls (all P&lt;0.05). The APC in the control, CM-CADe, and SD-CADe groups was 0.66, 1.04, and 1.16, respectively. The pAPC was 0.33, 0.53, and 0.64, respectively, and the AAPC was 0.07, 0.12, and 0.10, respectively. Both CADe systems showed significantly higher APC and pAPC than WLE. AADR and AAPC were improved in both CADe groups versus control, although the differences were not statistically significant. Conclusion Even in high adenoma detectors, CADe significantly improved ADR and APC. The AADR tended to be higher with both systems, and this may enhance colorectal cancer prevention.
Endoscopic ultrasound-guided choledochoduodenostomy: is the rate of stent dysfunction underestimated?
Authors: Marc Barthet
Journal: Endoscopy (2023)

In this issue of Endoscopy, Fritzsche et al. from Amsterdam present the results of their prospective study on endoscopic ultrasound-guided choledochoduodenostomy (EUS-CD) for the primary drainage of malignant distal biliary obstruction (MDBO) (SCORPION-p study) [1]. The authors reported very high technical and clinical success rates of 91% and 86%, respectively, which are comparable to those reported in the literature [2]. In a recent multicenter series with EUS-CD performed in patients with endoscopic retrograde cholangiopancreatography (ERCP) failure, the results were the same, with 92% and 86% technical and clinical success rates, respectively [3]. These rates were also confirmed in another systematic review and meta-analysis including lumen-apposing metal stents (LAMS) and self-expandable metal stents (SEMS), with technical and clinical success rates of 94.8% and 93.6%, respectively [4]. Therefore, the efficacy of EUS-CD is about 90% or more in the literature and the discussion should be focused on adverse events or recurrent jaundice, which have been reported to be 5.6% and 11.3%, respectively [5].
Endoscopic clipping-assisted endoscopic injection sclerotherapy in the treatment of esophageal varices
Authors: Bo Wu, Xincheng Xie, Zhuying Zhou, Chaojun Huang, Hai Wang
Journal: Endoscopy (2023)

Endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy (EIS) are important treatments for acute bleeding and secondary prevention of variceal bleeding [1] [2]. EVL is known for its lower risk of adverse reactions but is limited to superficial veins and requires a certain diameter of varicose veins [3]. In contrast, EIS can reach deep perforating vessels regardless of vessel diameter. However, EIS has limitations such as rapid dilution of sclerosing agents and an increased risk of distal embolism due to fast blood flow and abundant vasculature. To overcome these challenges, we have combined metal clipping, which has been used for a long time in the treatment of esophageal varices [4], with EIS to create endoscopic clipping-assisted EIS ([Video 1]), which improves sclerosing agent retention in varicose veins, reduces the amount used, and decreases the risk of distal embolism.
Efficacious resolution of a rectal subepithelial cold abscess via endoscopic submucosal excavation
Authors: Xinyue Mao, Silin Huang, Bo Li, Suhuan Liao, Ronggang Zhang, Jun Cai, Heng Yu
Journal: Endoscopy (2023)

A 39-year-old woman underwent a colonoscopy subsequent to episodes of hematochezia, and this revealed the existence of a rectal subepithelial mass, approximately 18 × 8 mm in size, covered with smooth, normal mucosa. Endoscopic ultrasound suggested that the lesion originated from the submucosal layer, locally infringing upon the muscularis propria, and that it showed homogeneous hypoechoic changes, clear boundaries, and was growing toward the lumen ([Fig. 1 a]). Computed tomography revealed a roundish elevated lesion with an envelope in the rectum, which exhibited significant enhancement of the envelope following contrast administration, but showed no evidence indicating lymphatic or organ metastasis ([Fig. 1 b]). The patient was hospitalized and underwent endoscopic excision of the lesion ([Video 1]). During the procedure, the lesion was found to be a tough mass, mostly located in the submucosal layer, and when submucosal dissection was performed, the underside of the mass was seen to intrude into the muscularis propria in a strip-like manner. Consequently, the myofibers adjacent to the mass were excised, revealing the root of the mass, which was completely dissected. The procedure was completed without any perforation of the wound, and closure was achieved employing nylon suture and metallic clips ([Fig. 2]). Postoperative antibiotics were administered to prevent infection, and the patient remained free of symptoms such as fever, abdominal pain, or hematochezia. Histopathologic study confirmed a deep encapsulated pyogenic inflammation, characterized by an accumulation of neutrophils, lymphocytes, plasma cells, and histiocytes forming an abscess ([Fig. 3]).
Novel pancreatoscope improves diagnostic yield of visual findings for intraductal papillary mucinous neoplasms
Authors: Takeshi Ogura, Taro Iwatsubo, Kimi Bessho, Nobuhiro Hattori, Hiroki Nishikawa
Journal: Endoscopy (2023)

Intraductal papillary mucinous neoplasms (IPMNs) are characterized by mucin-producing neoplastic epithelium, and, as a result, pancreatic dilatation is observed [1]. Among IPMNs, main-duct IPMN (MD-IPMN) has high potential for malignancy, and surgical resection is recommended [2]. Preoperative diagnosis at the site of the mural nodule has clinical impact, allowing the necessary surgical margins to be determined. According to a previous study [3], pancreatoscopy has a higher detection rate than other diagnostic modalities. A single-operator pancreatoscope may be useful [4], but because the working channel is small, aspirating mucin may sometimes be a challenge, and therefore the diagnostic yield may be reduced because of poor visualization. Recently, a novel pancreatoscope has become available (eyeMax; Micro-Tech Co., Ltd., Nanjing, China) ([Fig. 1]). The diameter of its working channel is 1.8 mm, and the dedicated biopsy forceps, with a cup length of 1.6 mm, allows large amounts of histological tissue to be obtained. Successful preoperative diagnosis for determination of the surgical margins of MD-IPMN using this novel pancreatoscope is described.
Percutaneous endoscopic peritoneal biopsy for a patient with unexplained ascites
Authors: Li Wang, Liansong Ye, Xue Zhang, Jiamin Qin, Yong Yan, Li-Ming Wen
Journal: Endoscopy (2023)

The efficacy of abdominal ultrasound, computed tomography (CT), and exfoliative cytology for determining the cause of unexplained ascites is limited. Peritoneal biopsy under laparoscopy is helpful for the diagnosis [1]. Herein, we present a novel technique of percutaneous endoscopic peritoneal biopsy (PEPB), which was performed in a 67-year-old woman with unexplained ascites.
Gastritis cystica profunda mimicking submucosal tumor
Authors: Li Zeng, Linmao Zheng, Bing Hu, Liansong Ye
Journal: Endoscopy (2023)

A 69-year-old man presented with a submucosal tumor in the anterior wall of the lower body of the stomach ([Fig. 1]). He reported no obvious discomfort. His medical history was significant for hypertension, which was controlled by oral administration of amlodipine. Physical examination detected no obvious abnormalities. Endoscopic ultrasound showed a solid cystic lesion, which had a clear boundary and originated from the muscularis mucosae ([Fig. 2]). Enhanced computed tomography confirmed the presence of a low-density lesion in the stomach ([Fig. 3]). At the patient's request, we performed endoscopic resection to determine the nature of the lesion ([Video 1]). During the procedure, a dual knife was used and submucosal injection was not performed. Complete resection of the lesion was achieved ([Fig. 4]). There was no bleeding or perforation. Pathology showed cystic dilatation of the gastric glands, with submucosal invasion ([Fig. 5]). Immunohistochemical studies were negative for CD34 and CD117 but positive for smooth muscle action (SMA) and desmin. Therefore, the diagnosis of gastritis cystica profunda (GCP) mimicking submucosal tumor was made.
Combination of endoscopic full-thickness resection and laparoscopic intragastric surgery for gastric submucosal tumor
Authors: Atsuki Maeda, Kunihisa Uchita, Takehiro Iwasaki, Hiromichi Yamai
Journal: Endoscopy (2023)

Gastric submucosal tumors (SMTs) can be reliably resected in a minimally invasive manner using endoscopic full-thickness resection (EFTR) because, for example, they do not require mesenteric processing. However, there are many issues regarding suture methods, device costs, technique difficulty, and suturing certainty. Laparoscopic intragastric surgery allows secure suturing of the stomach wall from within the stomach by laparoscopy [1]. Although the combination of these two methods has not been reported, our experience indicates that it enables safer and less invasive treatment. We are convinced that this technique is particularly well suited for patients in whom oral tumor retrieval is impossible or suturing is difficult using only a flexible endoscope because a laparoscopic port is required.
Emergency rescue esophageal stenting through retrograde and antegrade rendezvous gastroscopy for an iatrogenic complicated esophageal perforation
Authors: Yi Yang, Chuntao Liu, Chuyan Chen, Jie Yin, Xiaoye Liu, Peng Li
Journal: Endoscopy (2023)

Endoscopic submucosal dissection (ESD) is the primary treatment for superficial esophageal cancer [1]. Post-ESD esophageal stenosis is commonly managed with endoscopic balloon dilation [2]. We present the case of a 76-year-old man with esophageal rupture during balloon dilation for post-ESD stenosis after early-stage esophageal cancer treatment. Despite prophylactic glucocorticoid and repeated endoscopic radial incisions, stenosis recurred.
Transcriptomic profiling of the acute mucosal response to local food injections in adults with eosinophilic esophagitis
Authors: Mirelle T.A. Kleuskens, Maria L. Haasnoot, Johan Garssen, Albert J. Bredenoord, Betty C.A.M. van Esch, Frank A. Redegeld
Journal: Journal of Allergy and Clinical Immunology (2023)

Exposure of the esophageal mucosa to food allergens can cause acute mucosal responses in patients with eosinophilic esophagitis (EoE), but the underlying local immune mechanisms driving these acute responses are not well understood.
Pursestring encirclement before endoscopic submucosal excavation of a cecal submucosal tumor
Authors: Jinfeng Zhou, Jiangguo Zhang, Xiaoyin Zhang
Journal: Endoscopy (2023)

Endoscopic submucosal excavation (ESE) has been successfully applied to the resection of gastric submucosal tumors (SMTs) [1] [2] [3] [4], but rarely to colonic SMTs because of the inevitability of perforation and subsequent peritonitis. The perforation is usually difficult to close quickly using titanium clips, owing to the collapse of the operational field of view, which is hard to restore by insufflation of carbon dioxide. Here, we report a novel method, named "pursestring encirclement before ESE" (PSE-ESE) ([Video 1]), for the endoscopic excavation of a cecal SMT. With the use of PSE-ESE, closure of the colonic perforation became quick and easy.
CDC Guidelines for the Prevention and Treatment of Anthrax, 2023
Authors: William A. Bower, Yon Yu, Marissa K. Person, Corinne M. Parker, Jordan L. Kennedy, David Sue, Elisabeth M. Hesse, Rachel Cook, John Bradley, Jürgen B. Bulitta, Adolf W. Karchmer, Robert M. Ward, Shana Godfred Cato, Kevin Chatham Stephens, Katherine A. Hendricks
Journal: MMWR Recommendations and Reports (2023)

This report updates previous CDC guidelines and recommendations on preferred prevention and treatment regimens regarding naturally occurring anthrax.Also provided are a wide range of alternative regimens to first-line antimicrobial drugs for use if patients have contraindications or intolerances or after a wide-area aerosol release of Bacillus anthracis spores if resources become limited or a multidrug-resistant B. anthracis strain is used (Hendricks KA, Wright ME, Shadomy SV, et al.;